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General NPI Number Information
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NPI Number | 1013218478
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Entity Type | Individual
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Provider Name | JENNIFER WHITT REARDEN LGSW
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Gender | Female
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 11/16/2010
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Provider Practice Location Address
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Address Line | 151 9TH AVE NW
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City | CHILDERSBURG
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State | AL
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Zip | 35044-1231
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Country | US
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Telephone | 205-266-8043
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Fax | 205-378-3371
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Provider Business Mailing Address
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Address Line | 151 9TH AVE NW
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City | CHILDERSBURG
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State | AL
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Zip | 35044-1231
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Country | US
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Telephone | 205-266-8043
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Fax | 205-378-3371
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2136G
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License Number State | AL
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